Transcript www.disability-federation.ie

Presentation to The Disability Federation Of Ireland
Pat Healy – National Director Social Care
5th February, 2014
Vision – Strategic Context
Two Key Requirements to deliver Objectives
 Develop a new person centred model of care for older
people and people with disabilities
Reform
 Promoting independence and lifestyle choice as
far as possible
 Maintain people at home or in their own
community
 A sustainable model - “money follows the person”
Sustain
Service
Delivery
 Service Plan delivery within Resources, Targets &
Standards
 Incremental performance improvement
 Transition safely
What will be different for
Older People & People with Disabilities
 Clear and comparable information and advice to make good decisions
about their service - person centred models of care the norm, with ease
of access to services
 People will be involved in developing their own care-plan based on
standardised needs assessment which focuses on people’s strengths &
personal goals
 Maximised potential of local communities & social networks to sustain
people in their own homes and communities
 Increased control of their own resource through “money following the
person” budgeting
 Service users and their local communities will be heard & involved in all
stages of the process to plan and improve services
 A wider range of high quality options either through public, private or
voluntary providers - choices available and people informed
Social Care Policy Direction & Service Modelling
Disability Services – Priorities 2014
•Implementation Framework – Value for Money and
Policy Review
•People moving from institutional settings to homes
in the community
•Reconfiguration of day services and young people
leaving school / rehabilitation programmes
•Disability services for children and young people (0
– 18s)
•Service user involvement and quality in the
development of services
•Management and information systems
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Services for Older People – Priorities 2014
•Develop sustainable model for long stay
care - review of fair deal – nursing home
support scheme
•Develop an integrated of service for older
people – supporting older peoples
independence
Assessment of need – single assessment tool
Service user involvement
Research, demographic trends – planning &
research
Service improvement models and performance
management models
5
Governance & Accountability - Processes
National Level
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Directorate – Governing Body
Leadership Team
Planning, Performance & Assurance Group
Social Care Management Team
Head of Operations
&
Service Improvement
- Services for
Older Persons
Head of Operations
&
Service Improvement
- Disability Services
National Consultative Forum
Head of Planning,
Performance &
Programme
Management
Quality &
Standards
Assurance
Clinical
Lead
National Implementation Framework – Value for Money & Policy Review
Service Delivery
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Regional - RDPIs – Transition Period (RDOs)
ISA’s and Hospital Groups
Support Functions – Finance, HR, Shared Service, Communication
Reform
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Reform Programme Office (DOH)
System Reform Office (HSE) Leo Kearns
6
Social Care Division Operational Plan 2014
High Level Summary – Disability Services
Social Care Funding 2014
• The social care budget for 2014 is set at €3,055.3m which is a small
increase of 0.5% on the 2013 position
• This includes reductions of €31.3m, which are principally pay related
reductions associated with Haddington Road, the employment
control framework (moratorium) and incentivised career break.
• It also includes additional resource of €45m representing €14m
developments in disability services and additional resource of €31m
to cover deficits in disability and older people services.
• HRA (€11.5m) & related pay reductions (€4m) for Disabilities
• Further €80m to be allocated – across all Care Groups.
Disability Services – Key Points
•
Embarking on a large scale reform programme to implement the VfM and Policy
Review which will transform our model of service to a community based model of
person-centred care
•
National Implementation Framework Steering Group & National Consultative
Forum will support implementation
•
An additional investment of €14m and 130 additional staff will:
– Provide places for an estimated 1,200 young people leaving school or
Rehabilitative Training nationwide - 35 additional staff - €7m
– Provide “emergency” placements for people with disabilities whose care or
family circumstances have changed and who now require an immediate and
unplanned service response 15 additional staff - €3m.
– Roll out a new model of assessment and intervention, the objective of which
is to provide one clear referral pathway for all children (0 – 18s), irrespective
of their disability, where they live or the school they attend - 80 additional
therapy staff - €4m
•
Reconfiguring existing resources will:
– Deliver a more person-centred model of care and support, with more than
150 people moving to more appropriate homes in the community.
– Realisation of €5m efficiencies in line with the VfM and Policy Review
– Streamline governance arrangements
Social Care Division Operational Plan 2014
Detailed Actions – Making It Real
A Person Centred Model of Service & Supports
Strategic Groundwork – 2014
• National Implementation Framework Steering Group –
Implementation Plan
• Evaluate Demonstration Projects
• Develop baseline data & comprehensive evaluation process
• Develop national guidelines and process to support rollout of
congregated settings in 2015 and future years.
• Cross agency working with Local Housing Authorities
• Building a “community development” approach
Embedding Change in Social Care Services
A Person Centred Model of Service & Supports
• Specific Actions – 2014 - planned approach, responsive
management, consultation & learning e.g.
– School Leavers
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Identify cohort with DES / Providers – 1st Feb
Identify service providers to respond – 1st April
Advise School Leavers & Families - 30th June
Communication & Learning for 2015
– 150 to move on from congregated settings
– New Directions – translate learning from demonstration sites
– 0-18’s – model of assessment and intervention -one clear
pathway, irrespective of disability
Reform is Part of our Work Every Day
Service User & Community Involvement
• National Consultative Framework Process to enhance
involvement
• Maximise potential of local communities & social networks
– collaborate with DFI & other agencies
• Take a “whole system” approach in developing health and
wellbeing
• Local Communities will be heard – “Nothing About Us –
Without Us”
• Building a coalition of support with local communities,
voluntary partners, staff & unions and the political system
in achieving our shared objective
How we implement change is important
Quality & Standards
• Implement national HIQA standards for residential services
– Work with stakeholders during commencement of
registration and inspection
– Regional implementation groups and national reference
group
– Implement Children First in a standardised way
– Develop standardised assessment of need process & inform
resource allocation model
– Safe Guarding Adults – sign off of policy
Although care costs, poor quality care costs more
Client Safety is Paramount
Management & Information Systems
• Work with DOH on strategic information
framework
• Performance Indicators – move from output to
outcome focus
• Develop web based system to support easier
service user access to information and advice
• Information to support planning including unmet
needs
Joint Approach Required
Efficiency & Effectiveness
• VFM & Policy Review – step change in implementation
- realisation of €5m efficiencies
• Strengthening governance & streamline service
arrangements / agreements
• Shared service platform – real opportunities to leverage
the model to streamline how we operate
• Promoting merging & partnering of service providers
where appropriate
• Procurement measures
• Service improvement team developed to support and
validate measures
Efficiencies will be targeted proportionately
between the larger & smaller services
Public Service Stability Agreement 2013- 2016 (HRA)
• HRA flexibilities can be applied to all services
voluntary & statutory
• HRA (€11.5m) & related pay reductions (€4m)
• Enabling implementation of change programmes &
extraction of cost
– Review and change work practices, rosters as envisaged in Future
Health
– Additional Hours
– Reduction in head count etc
– Higher remuneration reductions
– Reorganisation and consolidation of services
– Redeployment and reassignment
– Some outsourcing options
HRA Supporting Change
Public Service Stability Agreement 2013- 2016 (HRA)
• Each area working with agencies must ensure that
–
–
–
–
verifiable,
achievable and
proportionate
cost reduction and productivity measures are set for all agencies.
• Each area must have robust and transparent processes in place to
verify delivery of same
• Each submission from the agencies must be stressed tested and
validated and quality assured by Area Manager
• Early verifiable implementation
• Focus particularly on the top 50, however, all agencies to complete
documentation, collaborative approach
• Questionnaire to be sent to all agencies receiving under €250,000
Social Care Division - Values
Our Mission – Why we exist
Our Values – How we operate
Our Vision – Where we want our organisation to be
Service
Passion for
Excellence
Community
Learning
Trust
Developing a shared vision & values
Making it real